Triplet heterotopic pregnancy after gonadotropin stimulation and intrauterine insemination diagnosed at laparoscopy: a case report

The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists. SMJ // Article Case Report Triplet Heterotopic Pregnancy After Gonadotropin Stimulation and Intrauterine Insemination Diagnosed at Laparoscopy: A Case Report Abstract Heterotopic pregnancy has been traditionally considered a rare event; however, with the use of assisted reproductive technology, the incidence of heterotopic pregnancies is increasing. Diagnosing a heterotopic pregnancy can be challenging. This report describes a 30-year-old female at 11 weeks' gestation with an intrauterine twin pregnancy after gonadotropin stimulation and intrauterine insemination who presented complaining of left lower quadrant abdominal pain with constipation and cramps. The patient was empirically treated for diverticulitis but failed to respond to therapy. A heterotopic triplet pregnancy was ultimately diagnosed at laparoscopy. Heterotopic pregnancy must be considered in the differential diagnosis of abdominal pain in the first trimester, especially in patients who conceived by means of assisted reproductive technology. Surgical treatment is the most frequently used method of treatment. Key Points * Heterotopic pregnancy is a rare occurrence; however, with the use of assisted reproductive technology, the incidence is increasing. * The diagnosis of heterotopic pregnancy must be considered in first-trimester pregnant patients who conceived with assisted reproductive technology and present with abdominal pain. * Several treatment modalities have been described for heterotopic pregnancies, but surgical treatment remains the most common. This content is limited to qualifying members. Existing members, please login first If you have an existing account please login now to access this article or view purchase options. Purchase only this article ($25) Create a free account, then purchase this article to download or access it online for 24 hours. Purchase an SMJ online subscription ($75) Create a free account, then purchase a subscription to get complete access to all articles for a full year. Purchase a membership plan (fees vary) Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.